DESCRIPTION: This Cooperative Agreement application is designed to decrease the burden of substance abuse in the United States. Currently, knowledge of emerging drug use practices is derived from sporadic case reports that lack clinical accuracy, and existing surveillance systems that lag in reporting time. We will accelerate the response to emerging drug abuse trends by establishing iN3, an innovative NIDA National Early Warning System Network that will rapidly identify, evaluate, and disseminate information on emerging drug use patterns. The iN3 will harmonize multiple data streams to detect emerging patterns of psychoactive drug use and adverse effects. At the heart of iN3 is its Scientific Advisory Group (SAG). Members will assess two synergistic data streams to identify emerging patterns of drug use. The first data stream will be derived from the Toxicology Investigators Consortium (ToxIC), an NIH-supported network of medical toxicologists who specialize in recognizing and confirming sentinel events involving psychoactive substances. ToxIC investigators are located at 17 sentinel sites across the U.S. The SAG, in collaboration with NIDA, will analyze reports from ToxIC investigators' interviews of patients with acute, subacute, and chronic effects of emerging drug use. The second involves measures of drug use derived from social media (Twitter feeds), Erowid (a psychoactive encyclopedia), and Bluelight (a drug use web forum). We will enhance the synergy between these data streams by leveraging our innovative information processing approach developed in NIH grant R21DA30571 (PREDOSE), to analyze new content on Twitter, Erowid, and Bluelight to identify emerging drug use trends, and, potentially, geolocations. Data from semi-automated content analysis will be disseminated among ToxIC investigators to identify patterns related to emerging psychoactive drug use. Conversely, information from ToxIC investigators' bedside interviews will improve the analytical precision of the PREDOSE+ platform. Information from these data streams will be integrated by the Harmonized Coordinating Center (HCC) for SAG review. The SAG will disseminate findings via rapid communications such as interactive websites, listservs, and conferences. Our interdisciplinary team has extensive experience in NIH-funded drug epidemiology and emerging drug use trends. The Specific Aims of this proposal are to: 1) Identify new episodes of emerging drug use in multiple community-level indicators; and 2) Disseminate information about occurrence, identity, clinical, and adverse effects of emerging drug use. Innovation: Correlating social media data sources with bedside clinical examinations is highly innovative. Significance: By integrating advanced content analysis into an existing clinical network of sentinel sites, iN3 has the capacity to advance the field of drug surveillance from a reactive to anticipatory science. Impact: iN3 will have a public health impact by providing a tool that can inform efforts to truncate and prevent outbreaks of emerging drug use.